Just south of Mosul, Iraq, is located a military base — currently a U.S. Army facility called the Logistical Support Area (LSA) — that has been alternately controlled by the U.S. military, Islamic State, Iraqi Security Forces, and even NATO, over the course of the past handful of years. The base is currently being used to support joint Iraqi-U.S. combat operations against ISIS in Mosul, and one of the more critical elements of that support is a Role II medical facility with the mission of treating wounded Americans (and Iraqis).
A U.S. military “Role II” facility denotes a “forward resuscitative surgery facility” to treat wounded servicemen and women in the combat zone. Think of a “M.A.S.H.” hospital from the old TV show, for lack of a better example. It is a deployed surgical facility, in a war zone, staffed by the full spectrum of surgical staff, and usually located on a forward-deployed military base. It is where the wounded first arrive after being injured in battle, and where they are surgically and medically stabilized before being sent on to a Role III (Bagram) facility, and beyond, to Germany and the United States.
On this particular base, the U.S. Navy’s Role II combat trauma medical facility sits at the corner of the flight line and a newly-named road, “Frank Butler Blvd.” This past November, the road was named for retired Navy SEAL and physician, Captain Frank K. Butler, for his pioneering contributions to Tactical Combat Casualty Care (TCCC).
Butler, who served in the early 1970s in both the Underwater Demolition Teams (UDT) and the SEAL Teams, went on to become a medical doctor in the Navy’s Medical Corps, and was one of the pioneers of what later came to be known as TCCC. The system of procedures, battlefield interventions, treatments, and protocols that make up TCCC are credited with saving thousands of lives in the past 15-plus years of American combat.
Butler’s contribution to the development of TCCC started with a 1996 paper in a supplement to the journal Military Medicine, entitled “Tactical Combat Casualty Care in Special Operations.” That 1996 article did as much as any other single piece of medical literature to nudge the military medical community forward in modernizing combat casualty care. The paper was co-authored by Army Lt. Col. John Haymann, and Navy Ensign E. George Butler (brother of Frank), also both medical doctors.
Frank Butler’s contributions to TCCC have continued unabated over the course of the 20 years since the publication of the 1996 paper. He served as the command surgeon of U.S. Special Operations Command (USSOCOM), the first Navy doctor to do so. He also served as the Biomedical Research Director for Naval Special Warfare Command (NSWC), the parent command of the Navy SEALs. Additionally, he is currently the chairman of the Committee on Tactical Combat Casualty Care (CoTCCC), which advises the Secretary of Defense on battlefield medical issues.
In 2006, Butler was the first recipient of, and the namesake for, the Frank K. Butler Award for Outstanding Contributions to TCCC. The award continues to be bestowed each year upon those who make significant contributions to TCCC.
The physician who spearheaded the effort to name the LSA road in honor of Butler, Navy Captain Thomas Craig, MD, who is currently serving at the Role II medical facility on Frank Butler Blvd, credited the road’s namesake with playing an integral role in saving numerous American lives. Per Craig, “TCCC has bought [injured American servicemen and women] the time to survive from the POI [point of injury] to get to a higher level of care.” That higher level of care is the Role II medical facility at which Craig serves.
The Role II personnel and equipment convoyed to the base in October of 2016, forced to travel over ground from Irbil, Iraq, due to the extensive damage inflicted on the base runway by U.S. aircraft back when ISIS controlled the base. Since October, the U.S. Air Force has taken over the runway, and restored it to a useable state.
The Role II medical facility includes a “fairly robust medical footprint, [rather than] a mobile footprint,” according to Craig, belying the facility’s semi-permanence. The Army had also been building with a view to being in the area for an extended period of time, though that course of action now remains up in the air, given the speed of the advance made on ISIS in Mosul. It remains to be seen if the base will be a short or long-term facility for the U.S. military.
Frank Butler Blvd is the main road that runs from the Army headquarters to the base runway. The Role II medical facility is situated on the road, near the airfield. According to Craig, if the base does end up being a long-standing facility, then Captain Butler will be well-represented by the location of the road. Per Captain Craig,
The route for injured warriors landing at the base, arriving from the point of injury, will travel quickly on Frank Butler Blvd to Medical. The TCCC that the warrior received on the battlefield, ensuring that they lived long enough to arrive to a higher medical echelon of care — basically, bridging their life from POI to surgical stabilization — will ride on the road named after the man who made it happen.”
A fitting tribute, indeed.
(Featured image courtesy of Bill Duncan).